Functional Results of the TKA with Non-resurfaced Patella according to Articular Degeneration of the Patella / 대한정형외과학회잡지

PURPOSE: We evaluated the functional outcome as degeneration of articular surface of the patella after total knee arthroplasty without resurfacing the patella. MATERIALS AND METHODS: From 2002 to 2003, 63 cases of 52 osteoarthritis patients who underwent total knee arthroplasty without resurfacing the patella as randomized selection were evaluated. Average age was 67.2 years old. Female were 49 patients, and male 3 patients Average follow-up periods were 32 months. Used implant were all PFC-sigma. Clinical outcomes was analyzed as Feller's patella score (perfect score; 30 points), anterior knee pain, crepitation according to the extent of involvement of articular surface of the patella and patello-femoral tracking. RESULTS: The Feller's patella score increased from mean 20.1 to 26.9 (p0.05). The patella score was low with patellar malalignment. Anterior knee pain after operation increased during postoperative 6 months according to the extent of degeneration of patellofemoral joint, but after 6 months there is no statistically significant differences except group 4 and all groups gradually decreased. Crepitation was increased during postoperative 1 year according to the extent of cartilage degeneration and after that its incidence decreased with time. CONCLUSION: The clinical results of total knee arthroplasty without resurfacing the patella was not influenced by the extent of degeneration of patello-femoral joint, but by alignment of patellofemoral joint. Anterior knee pain and crepitation increased in proportion to the extent of degeneration of patello-femoral joint in early period, but it fade out with time.

Patellar Nonresurfacing Versus Patellar Resurfacing in Total Knee Arthroplasty

PURPOSE: To compare the clinical, radiologic results and complications between the patellar non-resur-faced and resurfaced cases in total knee arthroplasty. MATERIALS AND METHODS: From March 1998 to May 2003, the subjects were 37 patellar non-resurfaced and 45 patellar resurfaced cases followed up more than a year among the patients who had total knee arthroplasty in degenerative arthritis. The results were evaluated by the range of motion, Hospital for Spe-cial Surgery (HSS) knee rating score, and Laurin's and Merchant's congruence angle. Student t-test was used in statistical analysis in comparison of both groups. RESULTS: In non-resurfaced group, the range of motion was incrased from 90.6 degree preoperatively to 108.6 degree postoperatively and HSS score from 62.6 to 84.1 respectively, while in resurfaced group, range of motion was increased from 88.2 degree preoperatively to 110.4 degree postoperatively and HSS score from 59.3 to 85.3. There were no significant differences between two groups (p>0.05). There were some patella-asso-ciated complications in each group, and revision due to patella-associated complications were 1 case (3%) and 2 cases (4%) each. So, patella-associated complications and revision rates revealed no significant dif-ferences (p>0.05). CONCLUSION: There is no difference in the clinical results and complications between patella resurfacing and selective non-resurfacing with relatively good cartilage, More follow up is needed for the necessity of revision due to patella-associated complications.